Friday, April 19, 2013 • Saturday, April 20, 2013 • Sunday, April 21, 2013
Psilocybin-Assisted Treatment for Alcohol Dependence
Michael Bogenschutz, MD
This presentation will review past clinical trials of the classic hallucinogens for addiction, discuss possible mechanisms of action, and present the design and preliminary results of an ongoing pilot study of psilocybin-assisted treatment of alcohol dependence. Before clinical research with these drugs was halted abruptly in the early 1970s, the use of LSD in the treatment of alcoholism was studied extensively, with additional studies involving other classic hallucinogens and other addictions. A recent meta-analysis of six randomized controlled trials of LSD for treatment of alcoholism (N = 536) demonstrated that the overall effect size of LSD treatment was clinically and statistically significant for up to 6 months after a single high-dose treatment. Candidate mechanisms include: acute objective brain effects, which can be measured at a number of levels; acute subjective effects, including mystical and other highly salient experiences; persisting effects, e.g. on brain structure and function, psychological states such as mood and anxiety, personality traits, beliefs, and values; and final change mechanisms directly related to substance use behavior, such as craving, self-efficacy, and motivation.
Dr. Michael Bogenschutz is Professor of Psychiatry and Psychology and Vice-Chair for Addictions and Clinical Research in the Department of Psychiatry at the University of New Mexico Health Sciences Center. Dr. Bogenschutz received his BA cum laude from Harvard University in 1985, and his MD cum laude from the joint Harvard/MIT Health Sciences and Technology Program in 1990. He joined the faculty of the Department of Psychiatry at the University of New Mexico in 1994 after completing his residency in psychiatry at the Cambridge Hospital in Cambridge, Mass. Dr. Bogenschutz has served on many committees and taskforces at the state and national level; has published over 100 articles, chapters, and abstracts; and has served as a reviewer for over a dozen peer-reviewed journals. He has been listed in Best Doctors in America continuously since 1998.
Psilocybin, Addiction, and End of Life
Steve Ross, MD
Since 2008, the NYU Psychedelic Research Group (established in 2006) has administered a moderate dose of psilocybin to 16 participants in a double-blind placebo-controlled trial of the efficacy of psilocybin-assisted psychotherapy in individuals with advanced cancer and psychosocial distress. We hypothesize that psilocybin administration in combination with existentially oriented psychotherapy can diminish psychological and spiritual distress in individuals with advanced cancer. Dr. Ross will present preliminary clinical observations and data from our study, in which a majority of patients have experienced acute and sustained reductions in death anxiety, existential distress, and depression; as well as increases in spiritual states and practices, and improved family system functioning. Recent groundbreaking research at Johns Hopkins has also demonstrated that psilocybin can occasion acute and enduring changes in the personality domain of openness. These findings have prompted several groups to explore using psilocybin-assisted psychotherapies to treat addictive disorders, which will also be discussed.
Stephen Ross, M.D., is Associate Professor of Psychiatry and Child & Adolescent Psychiatry at New York University School of Medicine and Associate Professor of Oral and Maxillofacial Pathology, Radiology, and Medicine at the NYU College of Dentistry. He directs the Division of Alcoholism and Drug Abuse and the Opioid Overdose Prevention Program at Bellevue Hospital Center in New York City. He is Director of Addiction Psychiatry at NYU Tisch Hospital and Director of the NYU Addiction Psychiatry Fellowship. He is certified in General and Addiction Psychiatry by the American Board of Psychiatry and Neurology (ABPN) and in Addiction Medicine by the American Society of Addiction Medicine (ASAM). Dr. Ross has received a dozen local and national teaching awards related to education of medical students, psychiatry residents, and post-graduate fellows. Dr. Ross is an expert on the therapeutic application of serotonergic hallucinogens to treat psychiatric and addictive spectrum illnesses. He directs the NYU Psychedelic Research Group and is Principal Investigator of the NYU Psilocybin Cancer Project. Dr. Ross receives his research funding from the National Institute on Drug Abuse and the Heffter Research Institute.
Johns Hopkins Psilocybin Research Project: Studies of Mystical Experience and Meditation in Healthy Volunteers, and Palliative Effects in Cancer Patients | 1.5 
Roland R. Griffiths, PhD
This presentation will review recent and ongoing psilocybin research at Johns Hopkins. Two recent studies showed that under carefully controlled conditions psilocybin can occasion profound personally and spiritually meaningful mystical-type experiences in healthy participants. Sixty-five percent of participants met criteria for having had a “complete” mystical experience. These effects were an increasing function of dose (5, 10, 20, and 30 mg/70 kg). Analysis showed that mystical-type experiences mediate sustained positive changes in attitudes, moods, personality, and behavior. One third of volunteers indicated they had a strong or extreme experience of fear sometime during the session. An ongoing study in novice meditators is exploring whether psilocybin-occasioned experiences can enhance the positive persisting effects of meditation and other spiritual practices. A therapeutic study is currently investigating psilocybin-facilitated treatment of anxiety and depression in cancer patients.
Desired Outcomes for : At the conclusion of the activity, learners will be able to:
Roland R. Griffiths, PhD, is Professor in the Departments of Psychiatry and Neurosciences at the Johns Hopkins University School of Medicine. His principal research focus in both clinical and preclinical laboratories has been on the behavioral and subjective effects of mood-altering drugs. His research has been largely supported by grants from the National Institutes of Health and he is author of over 300 journal articles and book chapters. He has been a consultant to the NIH, and to numerous pharmaceutical companies in the development of new psychotropic drugs. He is also currently a member of the Expert Advisory Panel on Drug Dependence for the World Health Organization. He has conducted extensive research with sedative-hypnotics and caffeine. About 12 years ago, he initiated a research program with the classic hallucinogen psilocybin, including studies of psilocybin occasioned mystical-type experience in healthy volunteers and cancer patients, and a pilot study of psilocybin-facilitated smoking cessation.
Psilocybin at the End of Life
Charles Grob, MD
This talk will present the findings of a pilot research investigation conducted at Harbor-UCLA Medical Center and the Los Angeles Biomedical Research Institute examining the safety and efficacy of psilocybin treatment in patients with advanced-stage cancer anxiety. This study, funded by the Heffter Research Institute, was the first formal effort in several decades designed to re-examine early promising findings using a psychedelic treatment model to address the psychospiritual demoralization often encountered by individuals with terminal cancer. The significance of observations made by psychedelic research pioneers, including Stanislav Grof and Walter Pahnke, will be described as will the background, methodological design, and results of contemporary investigations of psilocybin treatment. Particular examination will be made of safety parameters as well as potential mechanisms for observed therapeutic outcomes. Medical and cultural implications of developing a psychedelic treatment model at the end of life will be explored.
Charles S. Grob, MD is Director of the Division of Child and Adolescent Psychiatry at Harbor-UCLA Medical Center, and Professor of Psychiatry and Pediatrics at the University of California, Los Angeles School of Medicine. Prior to his appointment at UCLA, he held teaching and clinical positions at the University of California, Irvine College of Medicine and the Johns Hopkins University School of Medicine Departments of Psychiatry and Pediatrics. Dr. Grob conducted the first government-approved psychobiological research study of MDMA, and was the principal investigator of an international research project in the Brazilian Amazon studying the visionary plant brew ayahuasca. He has also completed and published the first approved research investigation in several decades on the safety and efficacy of psilocybin treatment in terminal cancer patients with anxiety. Dr. Grob is the editor of Hallucinogens: A Reader (Tarcher/Putnam, 2002) and co-editor (with Roger Walsh) of Higher Wisdom: Eminent Elders Explore the Continuing Impact of Psychedelics (SUNY Press, 2005). He is also a founding board member of the Heffter Research Institute..
The Beckley Foundation’s Program of Psychedelic Research
Amanda Feilding
Psychedelics afford a unique opportunity to expand our understanding of consciousness and its altered states, to develop techniques for enhancing consciousness, and to uncover new avenues of treatment and improved therapeutic techniques. In 2012, the Beckley Foundation/Imperial College Psychedelic Research Programme published the groundbreaking results from its series of studies into psilocybin using fMRI and MEG brain imaging technologies. Contrary to our expectation, we found that psilocybin decreases cerebral blood flow and brain activity, particularly in those regions that constitute the “default mode network,” the network of brain regions responsible for coordinating the flow of information through the brain and filtering out what is deemed superfluous. It is by decreasing the censoring activity of this network that psilocybin produces its characteristic effects: vivid sensory awareness, unconstrained cognition, and ego-dissolution. Our work has generated valuable insights into the transition from normal awareness to the altered awareness of the psychedelic state. It has also opened up new avenues of potential treatment for depression and other conditions. We are now working on a similar study using MDMA, and subject to approvals will shortly commence brain imaging research into LSD. Amanda will also describe Beckley’s (co-supported by Heffter) collaborative pilot study with Johns Hopkins University on the treatment of addiction with psilocybin-assisted psychotherapy and its outstanding results. Other Beckley collaborations include research with King’s College, University College London, and the Sechenov Institute in St. Petersburg.
Amanda Feilding is the founder and director of The Beckley Foundation (beckleyfoundation.org), which she set up in 1998, following a lifelong interest in consciousness research. In order to carry out the research, she has built up collaborative partnerships with leading scientists around the world, with whom she works on a wide range of projects investigating the neurophysiology, pharmacology and subjective effects of psychoactive substances such as cannabis, psilocybin, MDMA, LSD and ‘legal highs’. Her research work elucidates the neuroscientific underpinnings of consciousness, investigates how psychoactive substances work and how consciousness may be enhanced, and explores new potential therapeutic applications.
Psilocybin-Facilitated Treatment for Addiction: Smoking Cessation
Matthew W. Johnson, PhD
One of the intriguing lines of investigation into the therapeutic application of hallucinogens in the 1960s and 1970s was in the treatment of drug dependence. Prior research in non-dependent individuals has shown that under carefully prepared and supportive conditions, psilocybin can facilitate highly salient experiences with enduring personal meaning and spiritual significance, and moreover, that such experiences can lead to increases in personality openness. Embedding such highly meaningful experiences and resulting personality openness into drug dependence cessation may provide an enduring motivation for remaining abstinent. Cigarette smoking is a good model for studying drug dependence because users are less likely to be challenged by the many social and economic impairments that often accompany dependence on other drugs such as cocaine, heroin, and alcohol. We are conducting a pilot feasibility study in which psilocybin, administered under highly supportive and prepared conditions in up to three sessions, is combined with cognitive behavioral therapy for smoking cessation. Preliminary results are encouraging, with all five participants having quit on their first psilocybin session and showing biologically confirmed abstinence at all follow-up visits (up to one year for the first four participants).
Matthew W. Johnson, PhD is Assistant Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine. Dr. Johnson is an expert in addiction and the behavioral and psychological effects of psychoactive drugs in humans. He has published human drug administration research with cocaine, nicotine, caffeine, various sedatives, and hallucinogens including psilocybin, dextromethorphan, and salvinorin A. In 2008, he published recommended safety guidelines for the re-emerging field of human hallucinogen administration research, and in 2011 the first placebo-controlled study of the psychoactive effects of salvinorin A in humans. In published research with psilocybin he has examined mystical-type effects, persisting changes in attitudes and behaviors, personality change, and psilocybin effects on headache. He is currently studying the effects of psilocybin on a meditation program, and psilocybin in the treatment of anxiety and depression among cancer patients. Dr. Johnson is also principal investigator of an ongoing pilot study examining the putative anti-addiction efficacy of psilocybin in the context of tobacco smoking cessation.
Brain Imaging Studies with Psilocybin and MDMA | 1
Robin Carhart-Harris, PhD
Highlighting the results of two fMRI studies and one MEG study with psilocybin and an fMRI study with MDMA, Carhart-Harris will report the effects of both drugs on regional brain activity and brain network organization. Additionally, he will report the effects of both drugs on brain and subjective responses to personal autobiographical memory cues. A general theory will be presented on how psychedelics alter brain activity to alter consciousness and the implications of these brain imaging results for therapeutic applications of psychedelics will be discussed.
A general theory will be presented on how psychedelics alter brain activity to alter consciousness and the implications of these brain imaging results for therapeutic applications of psychedelics will be discussed.
Desired Outcomes for : At the conclusion of the activity, learners will be able to:
Robin Carhart-Harris completed his doctorate in psychopharmacology at the University of Bristol in 2009 after which he moved to Imperial College London to continue his fMRI research with the classic psychedelic drug psilocybin. In the last few years, Carhart-Harris & Professor David Nutt have built up a programme of research with psychedelics that includes fMRI and MEG imaging with psilocybin, fMRI with MDMA and soon an MRC-sponsored clinical trial to assess the efficacy of psilocybin as a treatment for major depression. Carhart-Harris has a review article published in Brain on the neurobiology of Freudian constructs and his work with psilocybin is now published in PNAS, the British Journal of Psychiatry, and Schizophrenia Bulletin. Carhart-Harris has been supported by the Beckley Foundation, the Neuropsychoanalysis Foundation, the Heffter Foundation, and MAPS.
The Beckley-Imperial Psychedelic Research Program
Dave Nutt, PhD
The Imperial College-Beckley Foundation research program has developed from the previously successful collaboration at the University of Bristol (UK). We conduct brain imaging research in the field of psychoactive drugs that have interesting and important effects on brain function and which may translate in therapeutic possibilities. So far, we have conducted the first UK psilocybin studies using both MRI and MEG techniques and also created a method for delivering smoked cannabis for use in imaging studies. We also collaborated with the UK Channel 4 television station to conduct the first study of MDMA that was broadcast live (“Drugs Live: The Ecstasy Trial”). This work is challenging, particularly in terms of dealing with regulatory issues, but our results show that overcoming these challenges can lead to hugely important insights into consciousness and core brain functions.
David Nutt, DM FRCP, FRCPsych, FSB, FMedSci, is currently the Edmund J Safra Professor of Neuropsychopharmacology and Head of the Centre for Neuropsychopharmacology at Hammersmith Hospital, Imperial College London. After completing his psychiatric training in Oxford, he continued there as a lecturer and then later as a Wellcome Senior Fellow in psychiatry. He then spent two years as Chief of the Section of Clinical Science in the National Institute of Alcohol Abuse and Alcoholism in NIH, Bethesda, USA. He is currently Chair of the Independent Scientific Committee on Drugs, Past-President of the European College of Neuropsychopharmacology (ECNP), Vice-President of the European Brain Council, and President of the British Neuroscience Association. Professor Nutt is a Fellow of the Royal Colleges of Physicians and Psychiatrists and a Fellow of the Academy of Medical Sciences. He has been editor of the Journal of Psychopharmacology for over a decade and acts as the psychiatric drugs advisor to the British National Formulary. He has published over 400 original research papers, a similar number of reviews and books chapters, eight government reports on drugs, and 26 books, including his most recent, Drugs without the Hot Air: Minimising the Harms of Legal and Illegal Drugs (2012).
Friday, April 19, 2013 • Saturday, April 20, 2013 • Sunday, April 21, 2013
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